Multiple myeloma--prognosis, treatment and survival in an eight year study

Data are presented from an unselected group of 76 patients with multiple myeloma, diagnosed over an eight year period in Christchurch. The median survival time was 31 months from commencement of treatment. The median survival of patients with Bence Jones proteinuria (29 months) was significantly shorter than those without this feature (47 months). Patients with lambda proteinuria had a median survival of 25.5 months and those with kappa proteinuria 32 months, but this difference was not statistically significant. The correlation of presenting anaemia, azotaemia or hypoalbuminaemia with a bad prognosis was confirmed. Immunosuppression of nonmyeloma immunoglobulins in patients with IgA or IgG myeloma was associated with a significantly worse median survival. Chemotherapy was discontinued in 11 patients at a variable period after one year of remission. In six cases the disease did not relapse, but relapse occurred in four cases and in three of these control could not be reasserted. One patient developed acute myeloblastic leukaemia five months after treatment was discontinued.